Cosmetic & Reconstructive Surgery Expert Forum
Breast reduction coverage
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Questions in the Cosmetic Surgery forum are answered by Dr. Howard Rosenberg and Dr. Wolfeld. Topics include bariatric surgery reconstruction, breast augmentation, chemical peels, cosmetic or reconstructive surgery, face lift, nose reconstruction, and tummy tucks.

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Breast reduction coverage

I am 23 years old, 5'1", 110 lbs, very athletic, and wear a 30E sometimes 32DD bra (which I'm starting to bust out of).  I have constant neck (curve is gone, completely hypolordotic), shoulder, upper back pain and severe tension headaches that render me useless for days at a time.  I've had physical therapy, chiropractic therapy, and am constantly icing and taking NSAIDS to relieve my pain.  I am convinced that a breast reduction will help me tremendously, but am concerned about the costs and how long and arduous of a process it would be to get my medical insurance to cover it (I have Pacificare).  Do I only need the surgeon's opinion in writing for approval or will I need several statement of medical necessity from the therapists and my own physician??  I am starting medical school this fall and am very concerned about the long days in class, hunched over a cadaver in the lab, and long study hours causing even further back and neck problems....concerned to the point that I may not physically survive medical school.  Any advice or reassurance would be so helpful.  Thank you!
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Most patient who undergo breast in my experience, wish hey had done the procedure earlier.  The relief from reduction of breast weight is significant.  Regarding insurance coverage for the procedure, that is depending on your coverage.  Your selected surgeon will document your condition with photos and a letter so that the insurance company can decide to issue a pre-authorization for surgery.
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